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Acute cardiac life support > Powerpoint > Flashcards

Powerpoint Flashcards

1
Q

Sinus node rate

A

60-100

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2
Q

Ectopic atrial pacemaker rate

A

60-80

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3
Q

Junctional ectopic pacemaker rate

A

40-60

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4
Q

Ventricular ectopic pacemaker rate

A

20-40

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5
Q

In a normal sinus rhythm, what is the P wave like in lead II

A

Upright

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6
Q

In normal sinus rhythm, what is the P wave like in aVR

A

Inverted

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7
Q

Rhythm in a premature ventricular contraction (PVC)

A

Irregular

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8
Q

P waves in PVC

A

Usually not seen

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9
Q

ST segment and T wave in comparison to the QRS complex in PVC

A

Opposite in polarity (discordant)

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10
Q

QRS complex in PVC

A

Premature (obviously) and wide

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11
Q

Is there a full compensatory pause in PVC?

A

Usually

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12
Q

Shockable rhythms

A

Vtach and vfib

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13
Q

Nonshockable rhythms

A

Asystole, Pulseless electric activity

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14
Q

Difference b/w defibrillation and synchronous cardioversion

A

In defib the shock is delivered w/out regards to the cardiac cycle, whereas with cardioversion the shock is delivered when the QRS complex is sensed

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15
Q

Indications for defibrillation

A

Vfib, pulseless monomorphic vtach, sustained polymorphic vtach

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16
Q

Indications for cardioversion

A 
Unstable afib
unstable aflutter
unstable momorphic vtach
unstable narrow-QRS tachycardia
unstable
unstable
unstable
unstable...
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17
Q

Rapid irregular rhythm with chaotic activity and no recognizable P, QRS, ST or T waves

A

Vfib

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18
Q

Treatment for Vfib

A

Defibrillation: biphasic, monophasic, AED

CPR for 2 minutes: 30:2 ratio

Epi 1 mg IV every 3-5 minutes or vasopressin 40U (in lieu of 1st or 2nd epi dose

Amiodarone 300 mg IVP (may repeat IV bolus once in 5 minutes @ 150 mg) or lidocaine (if amiodarone not available) 1.5 mg/kg (max 3 mg/kg)

Defib after each step + CPR then recheck rhythm

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19
Q

Signs of unstable cardiac events

A

Signs of hemodynamic compromise; lightheadedness, SOB, diaphoresis, hypotension, chest discomfort

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20
Q

Treatment for stable monomorphic VT

A

Amiodarone 150 mg IV over 10 minutes or
Procainamide 20-50 mg/min IV (initially), or
Sotalol 100 mg over 5 minutes

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21
Q

Tx for unstable monomorphic VT

A

synchronized cardioversion at 100 J

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22
Q

Tx for pulseless monomorphic VT

A

Same as vfib

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23
Q

Tx for sustained polymorphic VT

A

Defibrillator

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24
Q

If the is QT prolongation and a nonsustained polymorphic VT, what is the Tx

A

Mg Sulfate 1-2 g IV

This is torsades de pointes

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25
Q

No rate or rhythm discernible, no QRS complexs, P waves MAY be present (not usually)

A

Ventricular asystole

26
Q

Tx for ventricular asystole

A

Check leads, confirm asystole
Begin CPR
Establish IV access
Epi 1 mg IV every 3-5 min OR vasopressin 40U IV(1 dose to replace 1st or 2nd epi dose)

27
Q

When do you stop resuscitation

A

Persistent asystole or agonal EKG pattern despite appropriate ACLS protocol and no reversible cause identified

28
Q

Tx for PEA

A

Search for and treat reversible causes and…
Begin CPR
Establish IV access
Epi 1 mg IV repeat 3-5 minutes OR
Vasopressin 40 U (1 dose to replace 1st or 2nd epi dose)

29
Q

Potentially treatable cause of PEA and asystole (H’s)

A

Hypovolemia, hypoxia, hydrogen ion (acidosis), hyper/hypokalemia,
hypothermia

30
Q

Potentially treatable cause of PEA and asystole (T’s)

A 
Tablets (drugs)
Tamponade
Tension pneumothorax
Thrombosis, coronary
Thrombosis, pulmonary (embolism)
31
Q

Sinus tachycardia characteristics

A

Rate: 101-180
Rhythm: Regular
P waves: Uniform upright in II and always precedes a QRS complex

32
Q

2 types of pathways in AVNRT

A

Fast and slow pathways

33
Q

Describe the fast pathway in AVNRT

A

Conducts impulse rapidly but has a long refractory period

34
Q

Describe the slow pathway in AVNRT

A

Conducts impulses slowly but has a short refractory period

35
Q

AVNRT characteristics

A

150-250 BPM, usually 180-200
Ventricular rhythm is regular
P waves often hidden in QRS complex
QRS <.12 seconds

36
Q

Supraventricular tachycardia (SVT) that starts and ends suddenly

A

Paroxysmal SVT (PSVT)

37
Q

Rhythms that originate above the ventricles but the impulse travels via a pathway other than the AV node and bundle of His

A

AVRT; aka pre-excitation syndrome

38
Q

3 major forms of pre-excitation syndrome

A

Wolff-Parkinson White syndrome
Lown-Ganong-Levine (LGL) syndrome
Syndrome that involves the Mahaim fibers

39
Q

Short PR interval, Wide QRS complex, delta wave

A

Wolff-Parkinson-White syndrome

40
Q

Rate in WPW

A

60-100 usually

41
Q

PR interval in WPW

A

.12 seconds or less

42
Q

QRS complex in WPW

A

Usually >.12 seconds

43
Q

Atrial rate in afib; ventricular rate

A

Atrial rate is 400-600 (no discernible P waves) and ventricular rate is variable

44
Q

Tx for unstable afib

A

Cardiovert

45
Q

Tx for stable afib

A

Anticoagulate and control rate (BB, nondihydropyridine CCBs, digoxin)

46
Q

Atrial rate of 250-350 with saw-tooth pattern

A

Aflutter

47
Q

Tx for aflutter

A

Same as afib

48
Q

Most common wide-QRS tachycardia

A

VT

49
Q

Tx for unstable wide-QRS tachycardia

A

Cardiovert if monomorphic

Defib is polymorphic

50
Q

Tx for stable wide-QRS tachycardia

A

If monomorphic AND regular, consider adenosine

Otherwise…
Amiodarone 150 mg IV over 10 minutes or
Procainamide 20-50 mg/min IV (initially), or
Sotalol 100 mg over 5 minutes

51
Q

If you are giving adenosine for tachycardia, how much do you give for the 1st dose? 2nd dose?

A

1st: 6 mg rapid IV push follow with NS flush
2nd: 12 mg

52
Q

Coughing, squatting, breath holding, carotid sinus massage, application of a cold stimulus to the face, Valsalva, and Gagging are all examples of what?

A

Vagal maneuvers

53
Q

Rate considered bradycardic?

A

<60

54
Q

Tx for symptomatic sinus bradycardia

A

Atropine .5 mg IV

55
Q

P wave before each QRS, regular rhythm, prolonged (>.20 s) PR interval

A

1st-degree AV block

56
Q

PR interval lengthens each cycle until a P wave appears w/out a QRS

A

2nd-degree AV block, Type 1 aka Wenchkebach

57
Q

Every other P wave is followed by a QRS complex

A

2nd-degree AV block

58
Q

P wave and QRS complex are completely separate from each other

A

3rd-degree (Complete) AV block

59
Q

What do you do if atropine tx for unstable bradycardia is inneffective

A

Transcutaneous pacing OR
Dopamine infusion OR
Epinephrine infusion

60
Q

Doses of atropine, dopamine, and epi to give in bradycardia

A

Atropine: 1st dose .5 mg bolus, repeat every 3-5 min, max 3 mg

Dopamine IV: 2-10 mcg/kg/min

Epi IV: 20 mcg per min

Acute cardiac life support (5 decks)

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